Immunoallergy Department, Hospital da Luz Lisboa, Lisbon, Portugal.
Immunoallergy Department, Centro Hospitalar Universitário Algarve, Portimão, Portugal.
Pediatr Allergy Immunol. 2021 Aug;32(6):1278-1286. doi: 10.1111/pai.13511. Epub 2021 Apr 18.
Anaphylaxis is increasing at pediatric age; however, its characterization is hampered by underdiagnosis and underreporting. The aim of this study was to identify the causes of anaphylaxis in children and adolescents in Portugal, thus contributing to a better knowledge of its etiology, clinical manifestations, and management.
During a 10-year period, a nationwide notification system for anaphylaxis was implemented, with voluntary reporting by allergists. Data on 533 patients under 18 years of age with anaphylaxis were included.
Mean age was 8.5 ± 4.9 years, 61% were male; 45% had asthma. Mean age at the first anaphylaxis episode was 5.3 ± 4.7 years (ranging from 1 month to 17 years of age), 63% at pre-school age. Most reactions occurred at home (57%). Food-induced anaphylaxis was the leading cause (77%). The main culprit foods were cow's milk (32%), tree nuts (16%), shellfish (13%), egg (12%), fresh fruits (11%), fish (8%), and peanut (8%). Other causes included drugs (11%), insect sting (5%), cold-induced anaphylaxis (4%), exercise-induced anaphylaxis (2%), latex (1%), and idiopathic anaphylaxis (1%). Most patients (83%) were admitted to the emergency department; only 46% received adrenaline treatment. Recurrence of anaphylaxis occurred in 41% of the patients (3 or more episodes in 21%). An adrenaline autoinjector was used in 9% of the patients.
In the Portuguese pediatric population, food is the leading cause of anaphylaxis. Undertreatment with adrenaline and high recurrence of anaphylaxis highlight the need to improve both the diagnosis and the therapeutic management of this life-threatening entity.
在儿科人群中，过敏反应的发病率不断增加；然而，由于漏诊和漏报，其特征描述受到阻碍。本研究的目的是确定葡萄牙儿童和青少年过敏反应的原因，从而更好地了解其病因、临床表现和管理。
在 10 年期间，实施了一项过敏反应全国通报系统，由过敏专家自愿报告。共纳入了 533 名 18 岁以下过敏反应患者的数据。
平均年龄为 8.5±4.9 岁，61%为男性；45%有哮喘。首次过敏反应发作的平均年龄为 5.3±4.7 岁（年龄从 1 个月至 17 岁），63%发生在学龄前。大多数反应发生在家里（57%）。食物诱导的过敏反应是主要原因（77%）。主要的罪魁祸首食物是牛奶（32%）、坚果（16%）、贝类（13%）、鸡蛋（12%）、新鲜水果（11%）、鱼（8%）和花生（8%）。其他原因包括药物（11%）、昆虫叮咬（5%）、冷诱导过敏反应（4%）、运动诱导过敏反应（2%）、乳胶（1%）和特发性过敏反应（1%）。大多数患者（83%）被收入急诊部；仅有 46%接受肾上腺素治疗。41%的患者（21%发生 3 次或以上发作）发生过敏反应复发。9%的患者使用肾上腺素自动注射器。
在葡萄牙儿科人群中，食物是过敏反应的主要原因。肾上腺素治疗不足和过敏反应高复发率突出表明，需要改善这种危及生命实体的诊断和治疗管理。
